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Healthy obsessions

Lord Rees of Ludlow is surely right that significant outcomes are more likely to emerge when researchers are committed to – even obsessed with – tackling problems (“Tracing the trajectory between blue skies and the bottom line”, Opinion, 2 July). Nowhere is this more evident than in medicine and dentistry, where clinician-academics are motivated to initiate and lead rigorous and challenging trials of new treatments in large part because of continuing concerns for their own patients. So many lifesaving and life-enhancing discoveries have come from these evaluations.

But the source of this motivation is sorely lacking in some other public service disciplines because practitioners, teachers and nurses for instance, unlike doctors and dentists, mostly stop practising when they become academics. How much less likely it is that commitment to – even obsession with – solving the problems of the classroom and the hospital ward will be influential if real responsibility in these settings came to an end years previously. Diminished credibility with former peers as well as relatively low research impact was clear from the research for my 2014 report for the Cabinet Office, How to Achieve More Effective Services: the Evidence Ecosystem.

And Lord Rees makes another telling point, which is relevant to applied as well as fundamental research: it is focusing on the “tiny piece of the puzzle that seems tractable” which pays off best. Not only in fundamental science but also in public services and the retail sector, for example, does this preoccupation drive progress.

Jonathan ShepherdProfessor of oral and maxillofacial surgery and director of the violence research groupCardiff University

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